Running head: Public policy
Historical Perspective
Rodriko Sankey
Rick Humphress
Public Policy Analysis
April 23, 2017
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Public policy
Week 3 Assignment 1
President Clinton’s and Obama’s healthcare policies
The main reason for the development of Obamacare was to ensure there is patient’s
protection as well as avoidable health care in the United States for both the rich and the poor
alike. Healthcare is one of the best need for better survival of people, and that is why both
President Clinton and President Obama fought for it so as to assist the entire population. The
policy was enacted on March 10, 2010, and was signed by Obama and thus it became law. The
process of Obamacare policy making was initiated by the former President Clinton but was
implemented by President Obama during his tenure. The policy became into effect under the
leadership of the former President Obama and had served a great deal in helping people access to
medication and better healthcare (Manchikanti, 2015).
The policy was fueled by the state to some of the citizens with low living standards in the
United States and could not afford the medication and other healthcare facilities. Few people in
the United States are immigrants who came to America in search of better working conditions
and thus most of them are poor, and they are the one working hard in improving the economy of
the entire nation. President Clinton and Obama did promise the citizens on the better health care
through the implementation of different policies and thus the enactment and use of the
Obamacare which played a critical role in assisting Americans to have access to patient’s
protection as well as better health care facilities. The main urgency of the policy was as a result
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of the poor Americans who were provided unskilled labor in the country. The US government
were in a position to provide the service and thus the passing of the policy (Oberlander, 2016).
During the time of policy process making, United States had improved economic growth,
and this was as a result of the unskilled labor in the country. Since there was the most working
population in the entire country, the leadership came up with a policy to cover them regarding
medication and allow them to have access to medication. The economic growth of United States
is one of the best around the globe and thus the need to help its citizens in living a better life, and
one of the best ways is to ensure that they all have access to better healthcare facilities since
health is the first step to wealth.
Socially, Americans diverge when it comes to their beliefs, norms and the customs that
they hold on to like the country. To bring different cultures together and out the interest of the
entire country as the priority, there were a need to unite all Americans using some policies that
will apply to them all as one. One of the policies that played a very paramount role in uniting
Americans across social differences is the Obamacare which became available to them all. By
virtue of being an American, the Obamacare were functional and this united and brought some
sense of ownership among Americans and patriotism as a whole (Romney, 2015).
In the world of politics, the Obamacare received a lot of rejection both from the locals
and also in the international world. It is normal for any policy to receive critics from the political
world and this was one of the main challenges during the implementation of the policy because
of the differences which were fueled by the politicians. Obama was seen as winning more
Americans both the republicans and the democrats because of the policy which assisted all
regardless of the political difference and thus more rejection from the opponents. Even though
the policy were one of the best since it aimed at helping the less fortunate in the society have
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access to medication, it faced a lot of rejection from the political arena and even the current
president of the United States, Donald Trump administration is radically changing the policy
about Obama health care instead of enhancing it to fit the current situation in the United States.
The policy was more effective at the time of amendment due to the situations which were
prevailing at that particular time. The policy helped a lot of people have access to patient’s
protection and much better health care facility at that particular time, and since there has been a
lot of changes in the United States, there was a need to advocates for policy change so as to fit
the current prevailing situations. The current leadership wants to completely to get rid of the
policy because of some few issues, and this is not the most feasible solution since Americans
have tasted and seen the importance of the policy. The differences regarding social and political
need to be put aside and address the real issues affecting the people of American (Kilkenny,
2016). The Obamacare establishment was met with great opposition especially from the
Republicans who prefer the patient care systems of the health care.the republicans headed by
President Donald argued that, the patient-care systems enhance competition with a focus on
global markets.similary, the Republicans oppose the Obamacare due to fear in reductions of the
health standards when the health care is taken care of by the government.this would rather be
characterized by the compromise of the relationship between the doctor and patient.despite great
opposition from the republicans, the democrats hold their views that the Obamacare would help
people across different social status.current government headed by President Triumph have
radically changed the policies and principles that were outlined in the Obamacare.according to
Roomney, (2015), Obamacare policies not only favor the citizens of the United but also to the
immigrants who boost the economy.Rooney, (2015), further criticizes the Republicans who
oppose the Obamacare with a view of it being related to the Democrats.many people support the
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Obamacare since it is believed to be related to the Affordable care Act which helps in improving
the conditions of individuals who suffer from obesity in various states of the United states.
In conclusion, the Obamacare plays a critical role in setting a great history and picture in
the entire world in which different government can approach medication to its citizens and thus
help them live a good life. This policy ought to serve as a lesson to different leadership on the
different steps and sacrifices that a country ought to take so as to achieve a better living standard
of its people at large (Kilkenny, 2016).
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Public policy
References
Gerston, L. N. (2014). Public policy making: Process and principles. Routledge.
Kilkenny, S. (2016). Opportunities in Obamacare. Network Journal.
Lee, D. &. (2015). Optimal minimum wage policy in competitive labor markets. Journal of
Public Economics.
Manchikanti, L. &. (2015). Obamacare 2012: prognosis unclear for interventional pain
management. Pain Physician.
Oberlander, J. (2016). The future of Obamacare. New England Journal of Medicine.
Romney, M. (2015). Replacing Obamacare with real health care reform. New England Journal
of Medicine.
Running head: THE AFFORDABLE CARE ACT POLICY ANALYSIS
The Affordable Care Act Policy Analysis
Rodriko Sankey
Rick Humphress
Public Policy Analysis
May 14, 2017
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THE AFFORDABLE CARE ACT POLICY ANALYSIS
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Executive Summary
ACA is a healthcare policy in the developed and implemented in the US. The three government
arms, the legislature, judicial and the executive have actively involved in it development
approval and implementation (Coffin & Rak, 2013). The cost of healthcare services significantly
affects the economy of America, the state budget, and virtually every family's health. When the
cost of healthcare are high-priced, schooling for children, adult employment, and health lives of
the elderly become difficult to endure.
Affordable Care Act (ACA), alias the Obama Care Act, is a healthcare policy
wadeveloped and implemented in the US. The three government arms, the legislature, judicial
and the executive actively involved themselves in its development approval and implementation.
ACA was a significant healthcare reform made by the government of US under former President
Obama since the creation of Medicaid as well as Medicare in the year 1965. The ACA was
developed to aid the poor, the elderly and the disabled that were unable to afford medication bills
to have access to the required healthcare by increasing the coverage of Americans who could
access medication and other healthcare aspects. Affordability, quality, and accessibility were
healthcare issues the ACA was intended to achieve. Recommendations and suggestions of the
ACA include increased coverage of people who were able to afford the cost of healthcare
through insurance cover, improved quality of the medical care and accessible care to all
individuals including the disabled, the poor and the elderly. This paper outlines players alongside
the roles and functions played, who enhance the development approval and implementation of
the ACA that was purposely made as a health reform in the health sector to save and improve
lives of the Americans who could not afford the medical cost.
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Players Involved in the Policy
There are many players who have made ACA deliver as planned. Actors that participated
in the creation, approval, and execution of the ACA are both government and private
stakeholders. These actors played different roles and functions in the insurance policy of the
ACA. Examples of these players include the US government, pharmaceutical firms, insurance
companies, physicians, employers, patients, interest or lobbying groups, and the general public
(Saint Joseph's University, 2017). The government is the overall body that controls all activities
involved in the creation, authorization, and execution of the policy. Pharmaceutical firms are
companies that manufacture and sell medicine and other medical products and facilities. They
can either be public or private. Insurance companies can also be run on either private or public
basis. They offer protection services in the healthcare sector. Employers are owners of
businesses who provide employment opportunities to American citizens and pay them for labor
services they provide to their firms or companies. Physicians are one of the service providers in
healthcare facilities. Patients are citizens who are customers to some of the actors such as doctors
and pharmaceutical firms. On the other hand, interest groups are significant players in the
creation as well as the implementation of ACA. They push for legislation while focusing on their
targeted benefits. The functions and roles played by these actors are interrelated in nature as
highlighted next.
Roles and Functions of the Players
Patients
Patients receive medical services from the physicians (Saint Joseph's University, 2017).
They are customers to healthcare providers such as doctors, and they consume medical care
services and products. They have a right to health services, and they are responsible for ensuring
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they are healthy. Their function in the ACA was raising issues of quality of services given in
healthcare facilities as well as accessibility to medical care. Also, they provided opinions on
medical costs that make it difficult for them to have medical care.
Physicians
Physicians can be grouped as employees because they provide services they are paid for.
They provide services to patients since it is their fiducial responsibility to do so (Shipherd,
Walton, & Johnson, 2016). Although they are different from other actors in the healthcare
system, they are paid for services they provide to patients but a connection between a patient and
physician sacred faith that surpasses monetary payment. In the ACA doctors played a great
function in soliciting for policies that improved their working environment to improve patient
care and protection. Employers under the Obama Care Act provided provide the medical
insurance covers to their workers and varied with deductibles and co-pays. According to
Garunay (2016), ACA insurance policy also provided that those small businesses with less than
50 full-time employees and make below $ 250,000 would benefit more from a new affordable
quality cover. In this manner, employers enhanced access to healthcare to people who could not
afford the cost of medical services.
Insurance Companies
Insurance companies offered insurance services by selling the series in from premiums to
Americans. The sales of insurance covers were done either directly to patients or indirectly
through intermediaries of the government. They prioritize insurance covers in such a way that
they make high premiums sold. The firm link between insurance companies and the government
formed one of the major parts of the implementation of the ACA (Abraham, Simon, & KaracaMandic, 2015).
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Pharmaceutical Firms
Pharmaceutical companies manufacture and sell medicines and other medical products
recommended by professional medical doctors. Just like insurance companies, pharmaceutical
firms can either be private or public. The played the role of ensuring the manufacture products
are of meeting the required health standards quality and quality. They also ensure the product are
available at the time of need. The companies receive salaries through the lawmaking drug-benefit
programs of health insurance as necessary by the ACA. It helped the government make medical
costs affordable. (Philipson, Koijen, & Uhlig, 2016).
Government
The government is the core driver of the insurance policy in the ACA. Its response to the
poor, disable and elderly American who were unable to afford medical bill was the primary
trigger towards the health reform. The role of government in the ACA policy ran throughout the
process its development and adoption. The government has three arms, the legislature, judicial
and the executive that helped gear towards ACA implementation. The legislative branch created
and enacted the ACA, the judicial interpreted the policy, and the executive played the role of
implementing it (Joshi, 2015). The policy advocated for improvement of health insurance that
has enabled children access schooling without difficulty, grown-ups to work in a more
productive way and the elderly live a healthier longer life (Obama, 2016). According to Garunay
(2016), the ACA has reformed the health care through expansion and improvement of medical
coverage since the population or the uninsured American had been reduced from 16 percent (9
million people) in 2010 to 9.1% (29 million) in 2015. This a significant decrease of 46%.
Interest Groups
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Interest groups can be other actor discusses above or any other associations that help in
the entire process of enacting and adoption of the ACA policy while pursuing interest benefits.
Lobbying groups that include political individuals, some legislative, judicial and executive
members were also helpful in enforcing the legislation and implementation if the policy.
Pharmaceutical firms are interest groups that put pressure on legislation and execution of the
ACA insurance coverage so that at the end of it all they have profited through the sale of medical
product the improve the quality of healthcare.
Political Influence of the Players
Interest Groups or Lobbying Groups
Interest and groups had the energy to face the government and exert pressure on the
legislation and policy adoption. Interest groups such as pharmaceutical firms have the motive of
gaining more profits in their businesses apart from meeting the requirement of the ACA policy,
of manufacturing quality medical benefits and availing them accordingly. Pharmaceutical firms
are interrelated with the government since it is the government that sets the standards required
for the products. There have been conflicts in the prices established by private and public firms
about the products manufactured. They affect the ACA policy by enhancing quality healthcare
through production and sale of quality products.
Insurance Companies
These firms affected the prices of premiums they offer to individuals. Their primary
motive is to ensure all the poor, disabled and low-income earners in America have access to
healthcare by providing subsidized insurance covers. They also have the purpose of making
profits from the sales of insurance covers. They have an interrelation with the government in a
way that they receive funds from the government to cater for a given percentage of premium
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prices on medical covers for the poor, disabled and elderly Americans. Conflict in fluctuation of
premium prices due to inflation as well as disputes among insurance firms themselves due to
negotiated rates of premiums. These businesses have an influence on the policy in that it fosters
healthcare access (Abraham, Simon, & Karaca-Mandic, 2015).
Conclusion
The ACA policy was enhanced by many actors. The government, insurance firms,
pharmaceutical industries, physicians, patients and interest groups are among the players in the
adoption of this policy. The various functions and role played by these actors were essential tools
for the success of the ACA policy. Establishment of the policy, enacting, and implementation,
provision of insurance covers, manufacturing and sale of medical products are among the roles
that realized expansion and in the delivery of healthcare among the American. In turn, the ACA
positively impacted the health of American by increasing the coverage of people who have
access to quality and affordable medical care.
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References
Abraham, J. M., Simon, K., & Karaca-Mandic, P. (2015, January 01). IS The Medical Loss Ratio
a Good Target Measure for Regulation in the Individual Market for Health Insurance?
Health Economics, 24(1), 55-75.
Coffin, J., & Rak, S. (2013). Affordable Care Act. , 28, 5.). The Journal of Medical Practice
Management : Mpm, 28(5).
Garunay, M. (2016, July 11). President Obama Writes on Health Care Progress in the Journal
of
the
American
Medical
Association
_
whitehouse.gov.
Retrieved
from
obamawhitehouse.archives.gov: https://obamawhitehouse.archives.gov/
Joshi, N. K. (2015, March 01). Party Politics, Governors, and Healthcare Expenditures.
Economics & Politics, 27(1), 52-78.
Obama, B. J. (2016, August 2). United States Health Care Reform: Progress to Date and Next
Steps. Journal of American Medical Association: Clinical Review and Education, 525532. doi:10.1001/jama.2016.9797
Philipson, T. J., Koijen, R. S., & Uhlig, H. (2016, January 01). Financial Health Economics.
Econometrica, 84(1), 194-245.
Saint Joseph's University. (2017, January 27). Institute of Catholic Bioethics: Health Care
Reform. Retrieved from sites.sju.edu: https://sites.sju.edu/icb/health-care-reform-dutiesand-responsibilities-of-the-stakeholders/
Shipherd, J., Walton, H. M., & Johnson, L. (2016, January 01). The Psychologist's Role in
Transgender-specific Care with U.S. Veterans. Psychological Services, 13(1), 69-77.
Running head: PUBLIC POLICY-THE AFFORDABLE CARE ACT
The Affordable Care Act Policy Analysis
Rodriko Sankey
Rick Humphress
Public Policy Analysis
May 28, 2017
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Contents
Position in favor of the policy.................................................................................................... 2
Position against the policy ......................................................................................................... 3
Response to the argument for the policy.................................................................................... 4
Response to the argument against the policy ............................................................................. 5
Anecdote .................................................................................................................................... 6
Evidence ..................................................................................................................................... 6
References .................................................................................................................................. 8
The Affordable Care Act Policy Analysis
Position in favor of the policy
Among many diseases that affect people, the childhood obesity has been considered
to be a major problem for the United States citizens. Despite the recent decline, childhood
obesity is still found to be high. According to Coffin and Rak, (2013), the health institutions
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such as the CDC (The Centre for diseases and control) for the children and the young group
aged two to nineteen (2-19) years there has been the stable rate of the prevalence of the
childhood obesity. This is considered to be about seventeen percent (17%) and largely affects
about twelve million adolescents and children for the last decades. In favoring the
“Affordable Care Act,” several lower and middle-class Americans has found to be benefiting
from the act due to the affordability of the health insurance initiated by the Act. The
affordable care act primarily aims to ensure reduction of the rate of childhood obesity and
increment in tobacco consumption through education (Coffin & Rak, 2013). The grants of the
Act are used by the department of the public and private health in enhancing the emergency
medical services to the kids. In addition to reducing the obesity among children and
encouraging cessation from tobacco usage. Analysis by the government Medicaid shows that
one out three adults and out of six (1/6) adolescents and adults are obese. Due to the
introduction of the affordable care act, both the children health insurance programs and the
government Medicaid play vital and significant roles in reducing the prevalence of obesity
for the United States citizens. The plan was initiated through the improvement of the access
to the services of the healthcare which strives to achieve the healthy weight. Coffin and Rak,
(2013), illustrates that with the introduction and implementation of the new reforms, children
have been enrolled in these programs to undertake to screen, diagnostic with treatment
benefits. Another reason for the favor of the affordable care act is its provision of the
increased and broad coverage of for both the employees and employers. This covers the tax
credits to the small enterprises. Before the introduction of the Act, the small businesses were
unable to afford the healthcare coverage for their workers.
Position against the policy
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There is increased opposition to the Affordable Care Act especially from the
Republican of the United States who believe in the patient-care method of the heath care
systems. This systems base themselves in fostering and enhancing competition with free
markets and reduce costs of the healthcare. Republicans argue that through owning of the
health care by the government, there would be the reduction in the standards of health care.
They further believe that there would be the compromise of the physician-patient association,
extended waiting periods in the healthcare systems. However, they fear the results since they
use the evidence from the government health centers as proof to the whole world. The
Republican view association believes that the act would increase financial burden to the
states and specifically to the individuals. This organization firmly opposes the affordable care
act with every Republican voting against it as a reform that was signed into law by President
Obama. Another opposing opinion is that the Affordable Care Act has been found to violate
the constitution and laws of the United States (Joshi, 2015). This is seen through the change
of the article one clause from the section seven of the constitution which allows revenueincrement bills to emerge from the representatives’ house. However, this was considered as
tax from the ruling by the supreme court. This has created fear among the citizens who have
been advocating for better healthcare reforms in the case of destructive leadership.
Response to the argument for the policy
For the case for the Policy, there has been sharing of the common views about the
childhood obesity. However, obesity has been considered to have broad social and economic
effects on both the affected population and the states. Several perceptions have also emerged
on whether the United States government has a role and capability in reducing the prevalence
of obesity. Research by Pew Centre shows that the Democrats have more support on
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government playing the significant role in reducing the childhood obesity by a margin of
sixty to thirty-seven percent (60%-37%) (Garunay, 2016).However, only twenty percent
(20%) of the Republicans supported this with the majority opposing the government towards
playing the significant role in the health care.
Another argument emphasizes and focuses on the costs of the health to the upper-class
individuals residing in different parts of the states. With the exchanges and expansion of the
Medicaid, there is subsidization in insurance coverage for the modest means citizens. This is
through increasing taxes on the less-modest people. In addition to curbing the Medicare
spending growth. The conservatives are considered not to be enthusiastic concerning the
redistribution. However, they are skeptical about the redistribution which is not transparent.
There is also the principle in the establishment of the marketplaces for purchasing the
insurance among people. Garunay, (2016) argues that the Conservative plans have also been
initiated that help in featuring of the marketplaces yet the affordable care act exchanges offers
much more support rather than providing avenues on comparing different plans. The
conservatives shift the responsibilities about the regulation of the insurance market of an
individual from the government states to the federal government. This is applicable in
situations where partner exchanges have been established by the respective states according
to the rules of the federal government.
Response to the argument against the policy
Due to the introduction and implementation of the Affordable Care Act, there is
increased funds for several families, increased demand with the reduction in the
unemployment rate. Report from the Whitehouse government shows that about two million
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people from the United States had selected definite plans in health insurances marketplaces
by January and about eighty percent (80%) of the citizens are anticipated to join the program
(Garunay, 2016). This is due to the increased benefits obtained from the tax credits in
assisting in paying the premiums. The current provision of the Affordable Care Act has made
it efficient and reliable for the families in accessing the health care activities and services.
According to Birkland, (2011), the Affordable Care Act has also helped in achieving the
desired goals to the relatives and individuals. This, in turn, increased the demands for the
services and products by more people in the whole economy.
Anecdote
Most of the under-insured people always attend hospitals to seek medical care.
Unfortunately, the majority of these people have always turned away. Example, a patient
participated in the ER before proceeding to the intensive care unit (ICU) due to failure in the
respiratory system. Unfortunately, the lung cancer of the patient was found to invade the
airways and spread all over the body (Joshi, 2015). The patient was coughing for almost an
annual period which followed coughing up of blood. As an adult patient, the condition
worsened due to neglect and rejection from seeking medical care. The patient was found to
have lost the employment and had no any insurance cover. Therefore, the patient failed in the
search for the medical attention till it was late.
Evidence
The cost of the health has been and continues to be a burden to the budget of the
united states economically. Before the established of the Affordable Care Act, the new
reform had been addressed as an urgent issue by President Obama (Obama, 2016). The
president further elaborated that effects with current systems of health care are the causes of
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the economic challenges to the United States and other global countries. The cost of the
medical surprisingly accounts for (1/6) of the total economy of the United States of America
(USA). Currently, in the USA the cost of spending is about two trillion dollars which are
approximately seventeen percent of the (GDP) gross domestic products (Obama, 2016). The
health care cost includes the retail sales, revenues on medical equipment, premiums to the
health insurers. Therefore, this is evidently enough the Affordable Care Act.
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References
Acri, M. C., & Hoagwood, K. E. (2015). Addressing parental mental health within interventions
for children: A review. Research on social work practice, 25(5), 578-586.
Joshi, N. K. (2015, March 01). Party Politics, Governors, and Healthcare Expenditures.
Economics & Politics, 27(1), 52-78.
Obama, B. J. (2016, August 2). The United States Health Care Reform: Progress to Date and
Next Steps. Journal of American Medical Association: Clinical Review and Education, 525532. doi:10.1001/jama.2016.9797
Coffin, J., & Rak, S. (2013). Affordable Care Act. , 28, 5.). The Journal of Medical Practice
Management: Mpm, 28(5).
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